A patient™s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious.

Questions 31

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ATI RN Pharmacology Online Practice 2019 A Questions

Question 1 of 9

A patient™s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious.

Correct Answer: B

Rationale: In a patient with a hypertensive emergency, rapid and effective blood pressure reduction is crucial to prevent organ damage. The recommendation for IV administration of antihypertensive medications in this scenario is to titrate the medication to achieve a safe reduction in blood pressure, generally targeting a decrease in mean arterial pressure by no more than 25% within the first hour. The specific medication and infusion rate are dependent on the patient's clinical status and individual factors. Therefore, the maximum dose and duration of infusion must be tailored to the patient's response, with close monitoring by healthcare providers. Hence, determining a fixed time for the maximum dose of the drug to be infused is not appropriate in this critical care scenario.

Question 2 of 9

The client has MRSA and receives vancomycin (Vancocin) intravenously (IV). The nurse assesses an upper body rash and decreased urine output. What is the nurse's priority action?

Correct Answer: A

Rationale: Vancomycin, a glycopeptide antibiotic, is critical for treating MRSA but carries risks of hypersensitivity reactions (e.g., rashes) and nephrotoxicity (e.g., reduced urine output). The nurse's priority when observing an upper body rash and decreased urine output is to hold the next dose and notify the physician . This action prevents further drug administration that could worsen a potential allergic reaction or kidney damage, both serious adverse effects requiring immediate medical evaluation. An X-ray might assess lung involvement in severe cases but isn't the first step for these symptoms. An antihistamine could treat mild itching but risks masking a systemic reaction, delaying critical care. A urine specimen might confirm renal issues but doesn't address the urgency of stopping the drug. Holding the dose ensures patient safety while awaiting physician guidance, aligning with nursing protocols for adverse drug reactions, making A the most prudent and timely action.

Question 3 of 9

A 66-year-old man with a history of recurrent pulmonary infections and hypertension is managed with ethacrynic acid, which controls his hypertension well. He is often hospitalized and placed on gentamicin for his recurrent pulmonary infections. Which of the following adverse effects must the treating physician be keenly aware of?

Correct Answer: B

Rationale: Gentamicin, an aminoglycoside, risks ototoxicity-hearing loss , especially with repeated use. Ethacrynic acid, a loop diuretic, also has ototoxicity potential, compounding risk. Dizziness , nausea , vertigo , and vomiting (E) occur but are less specific. Monitoring hearing is critical in this scenario.

Question 4 of 9

The patient is receiving the benzodiazepine clonazepam (Klonopin) for the treatment of panic attacks. What is an important medication outcome for this patient as it relates to safety?

Correct Answer: D

Rationale: Clonazepam, a benzo, risks withdrawal (e.g., seizures) if stopped abruptly-patients knowing this ensures safe taper, per safety. Stevens-Johnson isn't linked-rash is rare. No diet restrictions apply (unlike MAOIs). Blood work isn't routine for benzos. Abrupt cessation's danger is key, protecting against rebound.

Question 5 of 9

A patient™s blood pressure elevates to 270/150 mm Hg, and a hypertensive emergency is obvious.

Correct Answer: B

Rationale: In a patient with a hypertensive emergency, rapid and effective blood pressure reduction is crucial to prevent organ damage. The recommendation for IV administration of antihypertensive medications in this scenario is to titrate the medication to achieve a safe reduction in blood pressure, generally targeting a decrease in mean arterial pressure by no more than 25% within the first hour. The specific medication and infusion rate are dependent on the patient's clinical status and individual factors. Therefore, the maximum dose and duration of infusion must be tailored to the patient's response, with close monitoring by healthcare providers. Hence, determining a fixed time for the maximum dose of the drug to be infused is not appropriate in this critical care scenario.

Question 6 of 9

Superficial bladder cancer can be treated by direct instillation of the antineoplastic antibiotic agent mitomycin (Mutamycin). This process is termed:

Correct Answer: B

Rationale: Intravesical administration involves the direct instillation of medication into the bladder, which is a common method for treating superficial bladder cancer. This approach allows high concentrations of the drug, such as mitomycin, to come into direct contact with the cancerous cells lining the bladder, minimizing systemic side effects. Intraventricular and intrathecal administrations are used for delivering drugs to the brain and spinal cord, respectively, while intravascular administration refers to intravenous delivery. Intravesical administration is specifically designed for bladder conditions, making it the correct answer.

Question 7 of 9

Antilipemic drug therapy is prescribed for a patient, and the nurse is providing instructions to the patient about the medication. Which instructions will the nurse include? (Select all that apply.)

Correct Answer: A

Rationale: A. Limit fluid intake to prevent fluid overload: Antilipemic drugs can sometimes cause fluid retention, so it is important for the patient to limit fluid intake to prevent fluid overload.

Question 8 of 9

Currently, there is no way to prevent myelosuppression. However, there are medications available to elicit a more rapid bone marrow recovery. An example is:

Correct Answer: A

Rationale: Epoetin alfa (Epogen, Procrit) is an example of a medication used to elicit a more rapid bone marrow recovery. It is a form of erythropoietin, which stimulates the production of red blood cells in the bone marrow. By stimulating red blood cell production, epoetin alfa can help in faster recovery from myelosuppression, a condition characterized by low blood cell counts. This medication is commonly used in patients undergoing chemotherapy or those with chronic kidney disease to manage anemia and improve overall quality of life. Therefore, epoetin alfa is the correct answer in this scenario as it specifically addresses the issue of bone marrow recovery.

Question 9 of 9

The nursing instructor prepares to teach student nurses about how mean effective doses of medications are related to clinical practice. As a result of the instruction, what is the best understanding of the student nurses?

Correct Answer: D

Rationale: Mean effective dose (ED50) affects 50% of a population, but individuals vary-some need more or less due to metabolism, weight, or genetics, a clinical reality. Severe side effects aren't 50%-that's toxicity. Ethnic differences influence response, but dose variation is broader. No effect in 50% misreads ED50. Dose adjustment reflects individual pharmacokinetics, key to practice.

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